Unintentional injuries
Citation
AIHW
Australian Institute of Health and Welfare (2021) Unintentional injuries, AIHW, Australian Government, accessed 04 October 2023.
APA
Australian Institute of Health and Welfare. (2021). Unintentional injuries. Retrieved from https://www.aihw.gov.au/reports/children-youth/unintential-injuries
MLA
Unintentional injuries. Australian Institute of Health and Welfare, 25 June 2021, https://www.aihw.gov.au/reports/children-youth/unintential-injuries
Vancouver
Australian Institute of Health and Welfare. Unintentional injuries [Internet]. Canberra: Australian Institute of Health and Welfare, 2021 [cited 2023 Oct. 4]. Available from: https://www.aihw.gov.au/reports/children-youth/unintential-injuries
Harvard
Australian Institute of Health and Welfare (AIHW) 2021, Unintentional injuries, viewed 4 October 2023, https://www.aihw.gov.au/reports/children-youth/unintential-injuries
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On this page:
- Key findings
- How many young people die from unintentional injuries?
- What are the leading causes of unintentional injury death?
- Have unintentional injury deaths changed over time?
- How many hospitalised cases for unintentional injuries are there?
- What are the leading causes of hospitalised unintentional injury cases?
- Have hospitalised unintentional injury cases changed over time?
- Are unintentional injury rates the same for everyone?
- Where do I find more information?
- References
- Technical notes
Key findings
- In 2017–2019, among 15–24 year olds, unintentional injuries contributed to almost 1 in 3 (32%) deaths and more than 2 in 5 (43%) injury deaths.
- In 2019, unintentional injury deaths contributed to 399 deaths; the most common causes were land transport accidents (60%), accidental poisoning (20%) and accidental drowning (8.0%).
- Between 2007 and 2019, unintentional injury deaths decreased (from 18 to 12 deaths per 100,000 young people) while, between 2007–08 and 2016–17, hospitalised cases for unintentional injury remained stable (1,788 and 1,740 per 100,000, respectively).
- In 2018–19, sports injuries accounted for 31% of all unintentional injury hospitalised cases (17,600 cases).
- Unintentional injury deaths and hospitalised cases were higher for males than females.
Injuries are the leading cause of death among young people (see Deaths) and a major cause of hospitalisation (AIHW: Pointer 2019).
Adolescence and young adulthood is a time when independence increases and legal adulthood begins. Greater independence brings the potential for more risky behaviour, which can lead to injury. Serious injury can have long-lasting effects on young people’s health and wellbeing, including on their social and emotional development and occupational roles (NPHP 2004). Most injuries can be prevented by identifying and removing the cause or reducing exposure to them (DoH 2018). In recognition of the impact of injury on all Australians, a new National Injury Prevention Strategy 2021–2030 is being developed to reduce injury (DoH 2020).
Injuries can be intentional (such as self-harm or assault) or unintentional. This section focuses on unintentional injury, presenting data on deaths and those injuries that result in hospital admissions. Injuries treated in other settings (including emergency departments, hospital outpatient clinics, general practice and allied health practices) are not included.
For information on intentional injuries, see Mental illness for self-harm and Crime and violence for assault.
Box 1: Data sources on unintentional injuries
Deaths data are sourced from the AIHW National Mortality Database (NMD). The database comprises information about causes of death and other characteristics of the person, such as sex, age at death, area of usual residence and Indigenous status. These data are collected in Australia by the Registrars of Births, Deaths and Marriages in each state and territory. The data are then compiled nationally by the Australian Bureau of Statistics (ABS) and supplemented with information from the National Coroners Information Service. The ABS codes the data according to the International Classification of Diseases and provides them for the AIHW NMD. For more information on injury deaths, including how they are defined, as well as adjustments for Victorian additional death registrations in 2019, see Technical notes.
Data on hospitalised injury cases are sourced from the AIHW National Hospital Morbidity Database (NHMD). The NHMD is a collection of episode-level records from data collection systems for admitted patient morbidity in Australian hospitals. It includes records for all episodes of admitted patient care from essentially all public and private hospitals in Australia.
Note that injury cases reported here do not include presentations to emergency departments. Data presented in this section will underestimate injuries requiring hospital treatment.
How many young people die from unintentional injuries?
In the 3-years from 2017–2019, among young people aged 15–24:
- injuries (intentional and unintentional) contributed to almost three-quarters of all deaths (73%) (see also Deaths)
- unintentional injury deaths comprised around 1 in 3 (32%) of all deaths and 2 in 5 (43%) injury deaths.
In 2019, among young people aged 15–24:
- unintentional injury deaths contributed to 399 deaths – a rate of 12 per 100,000 young people
- the rate of unintentional injury deaths for young males (19 per 100,000) was 3.8 times as high as that for young females (5.1 per 100,000 females). This pattern was consistent among those aged 15–19 and 20–24. However, the difference was greater among the older age group. The rate for males was:
- 3.9 times as high as the rate for females among those aged 20–24 (23 per 100,000 males compared with 5.9 per 100,000 females) (Figure 1)
- 3.6 times as high as the rate for females among those aged 15–19 (15 per 100,000 males and 4.1 per 100,000 females).
Figure 1: Unintentional injury deaths among young people aged 15–24, by age and sex, 2019
Note: These data have been adjusted for Victorian additional death registrations in 2019. See Technical notes for more details.
Chart: AIHW.
Source: AIHW NMD.
What are the leading causes of unintentional injury death?
In 2019, among young people aged 15–24, the 3 leading causes of unintentional injury death – accounting for 88% of unintentional injuries – were:
- land transport accidents – 60% of unintentional injury deaths, or a rate of 7.4 per 100,000 young people (see also Box 2: How many young people die on Australian roads?)
- accidental poisoning and exposure to noxious substances (pharmaceuticals) – 20% or 2.5 per 100,000
- accidental drowning – 8.0% or 1.0 per 100,000.
The 3 leading causes of unintentional injury deaths were the same for both sexes, with rates consistently higher for males, with:
- rates for land transport accidents just over 4 times as high for males as females (11.7 and 2.8 per 100,000, respectively) (Figure 2)
- rates for accidental poisoning by, and exposure to, noxious substances (pharmaceuticals) 2.8 times as high for males as females (3.6 and 1.3 per 100,000, respectively)
- accidental drownings were just over 4 times as high for males as females (26 compared with 6 for females, or rates of 1.6 and 0.4 per 100,000, respectively).
Figure 2: Leading causes of unintentional injury deaths among young people aged 15–24, by sex, 2019
Note: These data have been adjusted for Victorian additional death registrations in 2019. See Technical notes for more details.
Chart: AIHW.
Source: AIHW NMD.
Box 2: How many young people died on Australian roads?
In 2019, among young people aged 15–24:
- there were 225 on-road motor vehicle injury deaths, accounting for 1 in 5 (20%) of all unintentional on-road motor vehicle injury deaths
- on-road motor vehicle injury deaths made up 94% of all land transport accidents
- those aged 20–24 made up the highest proportion of any 5-year age group (12%); those aged 15–19 accounted for 7.8% of deaths
- the death rate among young males was 4 times as high as that for females (11 and 2.7 per 100,000, respectively).
- death rates increased with remoteness; compared with Major cities (4.3 per 100,000), rates were 2.5 times as high in Inner regional areas (11 per 100,000), 4.1 times as high in Outer regional areas (18 per 100,000) and 3.6 times as high in Remote and very remote areas (16 per 100,000)
- death rates in the lowest socioeconomic areas were 6 times as high as in the highest areas (12 compared with 1.9 deaths per 100,000, respectively).
Between 2007 and 2019, among young people aged 15–24:
- the rate for motor vehicle injury deaths fell by around 43% from 12 to 6.9 deaths per 100,000
- rates decreased for both sexes across both age groups. Comparing the 2007 and 2019 rates, the large rate difference was for females aged 15–19 (by 62% or from 7.5 to 2.9 deaths per 100,000) followed by females aged 20–24 (by 52%, or from 5.4 to 2.6 deaths per 100,000) (see Figure 3).
Figure 3: On-road motor vehicle injury deaths, among young people aged 15–24, by age and sex, 2007 to 2019
Note: These data have been adjusted for Victorian additional death registrations in 2019 (see Technical notes for more details).
Chart: AIHW.
Source: AIHW NMD.
Have unintentional injury deaths changed over time?
Between 2007 and 2019, among young people aged 15–24:
- unintentional injury death rates fell from 18 to 12 deaths per 100,000 young people
- the rates for both males and females fell over time. Comparing the 2007 and 2019 rates, the large rate difference (54%) was for females aged 15–19 (from 9.0 to 4.1 per 100,000). The second largest decrease (35%) was for males aged 15–19 (from 23 to 15 per 100,000)
- the rate for males was consistently higher than that for females, although the rate ratio fluctuated – from 4 times as high in 2010 to 2.6 times as high in 2014) (Figure 4).
Figure 4: Unintentional injury deaths among young people aged 15–24 by age and sex, 2007 to 2019
Note: These data have been adjusted for Victorian additional death registrations in 2019. See Technical notes for more details.
Chart: AIHW.
Source: AIHW NMD.
How many hospitalised cases for unintentional injuries are there?
In 2018–19, injury and poisoning accounted for 14% of all hospitalisations (see Technical notes) for young people aged 15–24 (AIHW 2020).
- For males aged 15–24, injury and poisoning was the top reason for going to hospital, contributing to almost a quarter (23%) of their hospitalisations.
- For females aged 15–24, injury and poisoning contributed to 8.2% of their hospitalisations (AIHW 2020).
In 2018–19, among young people aged 15–24:
- there were 57,400 hospitalised injury cases (see Technical notes for unintentional injuries – a rate of 1,771 per 100,000 young people
- males were 2.3 times as likely to be hospitalised for unintentional injuries as females (2,443 and 1,062 per 100,000, respectively). This pattern was consistent for both 15–19 year olds and 20–24 year olds (Figure 5).
Figure 5: Hospitalised unintentional injury cases among young people aged 15–24, by age and sex, 2018–19
Chart: AIHW.
Source: AIHW NHMD.
What are the leading causes of hospitalised unintentional injury cases?
In 2018–19, among young people aged 15–24:
- land transport accidents were the most common reason for hospitalised unintentional injury cases (22% or around 390 cases per 100,000 young people).
- They were also the most common reason for hospitalised unintentional injury cases among females (25% or 267 per 100,000) (Figure 6)
- exposure to inanimate mechanical forces (for example, injuries from being struck with an object, see also Technical notes was the second most common reason for hospitalised unintentional injury cases for all young people (21% or around 379 cases per 100,000).
- This cause was, however, the most common accidental injury among males (24% or 579 per 100,000) and the third most common for females (16% or 167 per 100,000)
- falls (for example, falls due to collision with, or pushing by another person; falls due to roller-skates, skateboards, scooters; falls due to slipping or tripping), see also Technical notes, were the third most common reason for hospitalised unintentional injury cases for all young people (19% or around 341 cases per 100,000) and for males (19% or around 456 cases per 100,000).
- Falls were, however, the second most common reason for females (21% or around 220 cases per 100,000).
For information on sports injuries, see Box 3: How many hospitalised cases are for sports injuries?.
Figure 6: Hospitalised unintentional injury cases for young people aged 15–24, by leading specific causes of injury, by sex, 2018–19
Chart: AIHW.
Source: AIHW NHMD.
Box 3: How many hospitalised cases are for sports injuries?
Sport plays a large part in the lives of many Australians; it has many health benefits (see Physical activity) and provides opportunities for social interaction (ABS 2011). However, playing sport is not without risk, and some sporting injuries can have long-term impacts.
In 2018–19, among young people aged 15–24:
- sports injuries accounted for 17,600 hospitalised cases, a rate of 543 per 100,000 young people. Sports injuries accounted for 31% of all unintentional hospitalised cases for this age group
- the sports injury rate was the highest of that for all age groups, and over twice that for children aged 0–14 (247 per 100,000) and 25–44 year olds (263 per 100,000)
- the rate for males was almost 3 times as high as that for females (801 per 100,000 and 271 per 100,000, respectively). This was true for both 15–19 year olds (3 times as high) and 20–24 year olds (2.9 times as high)
- the rate for 15–19 year old males was 1.6 times as high as the rate for males aged 20–24 (990 and 639 per 100,000)
- just over half of all hospitalised cases for sports injury were for football codes (51%). Injury from playing football codes was also the most common hospitalised sports injury for both males and females (55% and 37%, respectively) and for both 15–19 year olds and 20–24 year olds (53% and 47%, respectively)
- motorcycling (6.3%), basketball (5.5%), cycling (5.4%) and skateboarding (3.6%) had the next highest proportions of injury hospitalised cases for all young people
- for males, motorcycling (7.7%) was the second most common hospitalised sports injury, while cycling was the third (6.3%)
- for females, netball (13%) and trail or general horseback riding (9.8%) were the second and third most common hospitalised sports injuries.
Between 2007–08 and 2016–17, hospitalised cases for sports injury increased from 446 to 534 per 100,000 young people. Cases increased for both males (from 742 to 812 per 100,000) and females (from 134 to 243 per 100,000), and for both 15–19 year olds (from 549 to 662 per 100,000) and 20–24 year olds (from 348 to 423 per 100,000).
The largest rate differences between 2007–08 and 2016–17 were for females: an increase of 81% for 15–19 year olds (from 164 to 298 per 100,000), and 85% for 20–24 year olds (from 106 to 196 per 100,000) (Figure 7).
For more information on sports injuries relating to the whole of population, see Hospitalised sports injury in Australia, 2016–17.
Figure 7: Hospitalised cases for sports injury, young people aged 15–24, by age and sex, 2007–08 to 2016–17
Chart: AIHW.
Source: AIHW NHMD.
Hospitalisation rates are considerably higher when viewed as a proportion of the number of people who report playing sport, rather than as a proportion of the general population as a whole (see AIHW: Kreisfeld & Harrison 2020 for more details).
Across all sports and all age groups, 10% of people admitted to hospital due to a sports injury had life-threatening injuries. The sports with the highest proportions of life‑threatening cases were swimming and diving (27%), cycling (24%), equestrian activities (24%), wheeled motor sports (21%) and recreational walking (19%). Recreational walkers tend to be older than participants in most other sports. More than half of walkers hospitalised in 2016–17 were aged 65 or over (AIHW Kreisfeld & Harrison 2020).
Have hospitalised unintentional injury cases changed over time?
Due to a break in series in 2017–18, time-series analysis is presented only for 2007–08 to 2016–17 (see Technical notes for more details).
Between 2007–08 and 2016–17, among young people aged 15–24, the rate:
- of hospitalised unintentional injury cases remained stable (1,788 and 1,740 per 100,000, respectively). It reached its highest point in 2011–12 (1,806 per 100,000)
- for males was consistently higher than that for females. However, there was a decrease in the overall rate for males (from 2,703 to 2,455 per 100,000) and an increase for females (from 826 to 992 per 100,000).
In comparing the 2007–08 and 2016–17 rates, the largest rate decrease (12%) was for males aged 15–19 (from 2,826 to 2,484 per 100,000), while the largest rise (27%) was for females aged 20–24 (from 782 to 994 per 100,000) (Figure 8).
Figure 8: Hospitalised unintentional injury cases among young people aged 15–24, by age and sex, 2008–09 to 2016–17
Chart: AIHW.
Source: AIHW NHMD.
Are unintentional injury rates the same for everyone?
Injury deaths
In 2019, among young people aged 15–24, the unintentional injury death rate:
- was 1.5 times higher among Australian-born young people than among those born overseas (31 compared with 21 per 100,000)
- increased with remoteness. Compared with Major cities (9.3 per 100,000), it was 1.7 times as high in Inner regional areas (16 per 100,000), increasing to over 3 times as high for Remote and very remote areas (29 per 100,000) (Figure 9)
- was more than twice as high among those living in the lowest socioeconomic areas compared with the highest socioeconomic areas (16 per 100,000 compared with 7.5 per 100,000, respectively).
Figure 9: Unintentional injury deaths for young people aged 15–24, by population groups, 2019
Note: These data have been adjusted for Victorian additional death registrations in 2019. See Technical notes for more details.
Chart: AIHW.
Source: AIHW NMHD.
Hospitalised unintentional injury cases
In 2018–19, among young people aged 15–24, the rate of unintentional hospitalised injury cases was:
- more than twice as high for those living in Remote areas (3,564 per 100,000) and Very remote areas (3,496 per 100,000) compared with Major cities (1,530 per 100,000) (Figure 10).
In 2016–17, the rate was:
- 1.2 times as high for young people living in the lowest socioeconomic areas as for those in the highest areas (1,836 and 1,476 per 100,000, respectively) (see also Technical notes).
Figure 10: Hospitalised unintentional injury cases for young people aged 15–24, by remoteness areas, 2018–19
Chart: AIHW.
Source: AIHW NHMD.
Where do I find more information?
For information on topics related to injuries in this report, see:
- Crime and violence for assault
- Mental illness for self-harm.
For information on Indigenous young people and injuries, see:
- Section 7.1, Prevalence of health conditions and injury of Aboriginal and Torres Strait Islander adolescent and youth health and wellbeing 2018
- Measure 1.03, Injury & poisoning in Aboriginal and Torres Strait Islander Health Performance Framework (HPF) report 2020.
For information on:
- injury deaths and hospitalised cases for children aged 0–14, see Australia’s children
- injury deaths for children aged 0–14 disaggregated by states and territories, see ‘Injury deaths’ in Children’s Headline Indicators
- all hospitalised injuries for young people, see: Hospitalised injury in children and young people 2017–18.
- whole-of-population injury hospitalisations and deaths (including disaggregation for young people aged 15–24), see: Injury in Australia, 2017–18
- land transport crashes, see: Hospitalised injury due to land transport crashes
- eye injuries, see: Eye injuries in Australia, 2010–11 to 2014–15
- road deaths, see: the Bureau of Infrastructure and Transport Research Economics (BITRE) Road safety statistics
- sports injuries, see Hospitalised sports injury in Australia, 2016–17.
ABS (Australian Bureau of Statistics) 2011. Australian social trends, June 2011. Canberra: ABS.
AIHW 2020. Principal Diagnosis data cubes. Cat. no. WEB 216. Canberra: AIHW. Viewed 26 March 2021.
AIHW: Pointer SC 2019. Trends in hospitalised injury, Australia 2007–08 to 2016–17. Injury research and statistics series no. 124. Cat. no. INJCAT 204. Canberra: AIHW.
AIHW: Kreisfeld R & Harrison JE 2020. Hospitalised sports injury in Australia, 2016–17. Cat. no. INJCAT 211. Injury Research and Statistics Series no. 131. Canberra: AIHW.
Centre for Epidemiology and Evidence 2019. Reporting of hospitalisation-related indicators on HealthStats NSW: impact of changes to emergency department admissions. Statistical method no. 8 April 2019. HealthStats NSW. Sydney: NSW Ministry of Health.
DoH (Department of Health) 2018. Injury prevention in Australia. Viewed 7 October 2020.
DoH 2020. National Injury Prevention Strategy 2020–2030. Viewed 7 October 2020.
NPHP (National Public Health Partnership) 2004. The National Injury Prevention and Safety Promotion Plan: 2004–2014. Canberra: NPHP.
AIHW National Mortality Database
- Information about deaths is collected on death certificates and certified by either a medical practitioner or a coroner. Registration of deaths is compulsory in Australia and is the responsibility of each state and territory Registrar of Births, Deaths and Marriages under jurisdiction-specific legislation. On behalf of the Registrars, deaths data are assembled, coded and published by statistical agencies. These agencies have varied since 1900 and have included state based statistical offices, the Commonwealth Statistician's Office and the Commonwealth Bureau of Census and Statistics, now known as the Australian Bureau of Statistics (ABS). COD URF data are provided to the AIHW by the Registries of Births, Deaths and Marriages and the National Coronial Information System (managed by the Victorian Department of Justice) and include cause of death coded by the ABS. The data are maintained by the AIHW in the National Mortality Database.
- Causes of death are coded by the ABS to the International Statistical Classification of Diseases and Related Health Problems (ICD).
- Deaths in this report are counted according to year of death registration. Note that a proportion of deaths occur in a given calendar year but are not registered until subsequent years.
- Deaths registered in 2016 and earlier are based on the final version of cause of death data; deaths registered in 2017 are based on the revised version; deaths registered in 2018 and 2019 are based on the preliminary version. Revised and preliminary versions are subject to further revision by the ABS.
- For more information about Australian mortality data, including scope and coverage of the collection and a quality declaration, please refer to Deaths, Australia and Causes of death, Australia available from the ABS website.
- For remoteness: Geography is based on area of usual residence—Statistical Local Area Level 2 (SA2)—classified according to Remoteness Area 2016. Correspondence files are sourced from Australian Statistical Geography Standard (ASGS): Volume 1 - Main Structure and Greater Capital City Statistical Areas, July 2016 (ABS cat. no. 1270.0.55.001).
- For socioeconomic areas: Geography is based on area of usual residence—Statistical Local Area Level 2 (SA2)—classified according to into population-based quintiles according to the Socio-Economic Indexes for Areas (SEIFA) 2016 Index of Relative Socio-Economic Disadvantage (IRSD). Correspondence files are sourced from Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia, 2016 (ABS cat. no. 2033.0.55.001).
- Deaths had unknown/missing area of usual residence includes deaths where place of usual residence was overseas, no fixed abode, offshore and migratory, and undefined.
- Country of birth are coded to Standard Australian Classification of Countries (SACC), 2016 (ABS cat. no. 1269.0).
- The number of deaths of children attributed to suicide can be influenced by coronial reporting practices. Reporting practices may lead to differences in counts across jurisdictions and this should be taken into account when interpreting data. For more information on issues associated with the compilation and interpretation of suicide data, see ABS report 3303.0 - Causes of Death, Australia, 2018 Explanatory Notes 91 to 100. The ABS is not aware of any recorded suicide deaths of children under the age of 5 years.
- Population data are sourced from the Australian Bureau of Statistics report: ABS 3101.0 - Australian Demographic Statistics.
- Cause of death information for deaths from 1997–2019 are classified according to the World Health Organisation's tenth edition of the International Classification of Deaths (ICD-10). Online version of ICD–10 codes.
- ICD version and years: ICD–10 1997–present
- Care needs to be taken in interpreting data registered in Victoria in 2019. A time series adjustment has been applied to causes of death to enable a more accurate comparison of mortality over time. When the time series adjustment is applied, deaths are presented in the year in which they were registered (i.e. removed from 2019 and added to 2017 or 2018). As a result, totals do not equal the sum of their components. See Technical note: Victorian additional registrations and time series adjustments in Causes of death, Australia, 2019 (ABS Cat. no. 3303.0) for detailed information on this issue.
- For more information on data quality, see:
- Injury deaths criteria:
- Deaths were regarded as due to injury and included in this report if they met the following criteria:
- deaths registered by the selected year(s); and
- the underlying cause of death as an external cause code in the range V01–Y36; or
- at least 1 associated cause of death as an external cause code in the range V01–Y36 and at least 1 other associated cause of death was a code for injury (S00–T75 or T79).
- The number of injury deaths in this section are based on multiple causes of death, and so will differ to those in the ‘Deaths’ section which are based on underlying causes of death only.
- Deaths were regarded as due to injury and included in this report if they met the following criteria:
- External cause codes for unintentional injury deaths:
- Land transport accidents (V01–V89)
- Other transport accidents (V90-V99)
- Falls (W00–W19)
- Exposure to inanimate mechanical forces (W20-W49)
- Exposure to animate mechanical forces (W50-W64)
- Accidental drowning and submersion (W65-W74)
- Other accidental threats to breathing (W75–W84)
- Exposure to smoke, fire and flames (X00-X09)
- Contact with health and hot substances/Burns and scalds (X10–X19)
- Accidental poisoning by and exposure to noxious substances (X40-X44) (pharmaceuticals)
- Accidental poisoning by and exposure to noxious substances (X45-X49) (other substances)
AIHW National Hospitals Morbidity Database (NHMD)
- Hospitalisations and hospitalised injury cases:
- This section distinguishes between hospitalisations and hospitalised injury cases. Hospitalisation is used to describe an episode of hospital care that starts with the formal admission process and ends with the formal separation process. Elsewhere also referred to as separations.
- Injury hospitalisations are classified using the principal diagnosis in the ICD–10–AM range S00–T98 (Injury, poisoning and certain other consequences of external causes)
- Hospital injury cases – estimated as the number of injury separations, less those records where the mode of transmission was ‘Admitted patient transferred from another hospital’. These transfers are omitted to reduce over-counting. For more details, see Hospitalised injury (incident) cases below.
- Hospitalised injury (incident) cases:
- Estimating incident cases: Each record in the NHMD refers to a single episode of care in a hospital. Some injuries result in more than 1 episode in hospital and, hence, more than 1 NHMD record. This can occur in 2 main ways:
- a person is admitted to 1 hospital, then transferred to another or has a change in care type (for example, acute to rehabilitation) within the 1 hospital
- a person has an episode of care in hospital, is discharged home (or to another place of residence) and is then admitted for further treatment for the same injury, to the same hospital or another one.
- The NHMD does not include information designed to enable the set of records belonging to an injury case to be recognised as such. Hence, there is potential for some incident injury cases to be counted more than once, which occurs when a single incident injury case results in 2 or more NHMD records being generated (i.e. hospitalisations), all of which satisfy the selection criteria being used.
- Information in the NHMD enables this problem to be reduced, though not eliminated. The approach used for this report makes use of the ‘Mode of admission’ variable, which indicates whether the current episode began with a transfer from another acute care hospital. Episodes of this type are likely to have been preceded by another episode that also met the case selection criteria for injury cases, so are omitted from our estimated case counts.
- This procedure should largely correct for over-estimation of cases due to transfers, but will not correct for over-estimation due to re-admissions.
- Estimating incident cases: Each record in the NHMD refers to a single episode of care in a hospital. Some injuries result in more than 1 episode in hospital and, hence, more than 1 NHMD record. This can occur in 2 main ways:
- Case selection criteria:
- principal diagnosis in the ICD–10–AM range S00–T75 & T79 using ICD–10–AM, but excluding any with Z50 Care involving use of rehabilitation procedures appearing in any additional diagnosis field
- mode of admission was not a transfer from another acute hospital. (to reduce multiple counting of cases.)
- External cause codes for unintentional injury hospitalised cases:
- Land transport accidents (V01–V89)
- Other transport accidents (V90-V99)
- Falls (W00–W19)
- Exposure to inanimate mechanical forces (W20-W49)
- Exposure to animate mechanical forces (W50-W64)
- Exposure to smoke, fire and flames (X00–X09)
- Accidental drowning and submersion (W65-W74)
- Other accidental threats to breathing (W75–W84)
- Contact with health and hot substances/Burns and scalds (X10–X19)
- Accidental poisoning by and exposure to noxious substances (X40-X44) (pharmaceuticals)
- Accidental poisoning by and exposure to noxious substances (X45-X49) (other substances)
- Adjusting for changes to rehabilitation coding:
- A change in coding practice for ICD–10–AM Z50 Care involving the use of rehabilitation procedures has necessitated a change to the standard record inclusion criteria for NISU reports of hospital admitted injury cases. The change applies to episodes that ended on 1 July 2015, or later. For details of the change see ‘Box 4.2’ in Admitted patient care 2015–16: Australian hospital statistics (AIHW 2017).
- Due to the change in coding practice, an increase in the numbers of separations in 2015–16 with a principal diagnosis in the ICD–10–AM Chapter 19 Injury, poisoning and certain other consequences of external causes (S00–T98) range occurred (approximately, an additional 60,000 records).
- In order to minimise the effect of the coding change on the estimation of injury occurrence and trends, a change to the case estimation method used by NISU was required. Records with Z50 either as Principal Diagnosis or as Additional Diagnosis are now omitted by NISU in data-years both before and after the coding change. The change to data prior to 2015–16 amounts to an adjustment of less than 0.1% of records. Where injury trends are presented by principal diagnosis for years prior to 2015–16, data will not be directly comparable for previous reporting periods.
- For more information on hospitals admitted patient care data quality for 2018–19, see Appendix A in Admitted patient care 2018–19 Appendixes
- Injuries due to exposure to inanimate mechanical forces are those that occur from striking against or being struck by other objects, exposure to other and unspecified inanimate mechanical forces, contact with knife, sword or dagger, contact with glass window.
- Injuries due to falls include falls on the same level, including those due to collision with or pushing by another person, those involving pedestrian conveyances (e.g., roller-skates, skateboards, scooters) slipping, tripping, stumbling, falls from one level to another (e.g. from stairs, steps, ladders), involving playgroup equipment or out of or through building or structure.
- Hospitalised injury cases and break in series: changes to NHMD inclusions for 2017–18:
- The emergency department admission policy was changed for New South Wales hospitals in 2017–18. Episodes of care delivered entirely within a designated emergency department or urgent care centre are no longer categorised as an admission regardless of the amount of time spent in the hospital. This narrowing of the categorisation has had the effect of reducing the number of admissions recorded in NSW for the 2017–18 financial year. For New South Wales the effects were a significant decrease (3.7%) in all public hospital admissions in 2017–18 compared with 2016–17. The impact of the change was felt disproportionately among hospitalisations for injury and poisoning. According NSW Health the number of hospitalisations for injury and poisoning in NSW decreased by 7.6% between 2016–17 and 2017–18, compared to a usual yearly increase of 2.8% (Centre for Epidemiology and Evidence 2019).
- The change in NSW’s emergency department admission policy may have had different effects on case numbers within different external cause categories. This is because different types of injury have a different likelihood of requiring prolonged care in an emergency department, but without an admission to a hospital ward.
- Consequently, fewer injury separations are reported than would have been seen had the NSW policy not changed, for most analyses.
- Due to the size of the contribution of NSW data to the national total, Australian data from 2017–18 should therefore not be compared with data from previous years.
- Hospitalised unintentional injury cases and socioeconomic status:
- Due to possible data quality concerns affecting 2017-18 and 2018-19 hospitalised unintentional injury data by socioeconomic areas, results for 2016-17 are presented in this section.
- Population data:
- Denominators for hospitalised injury cases are estimated resident population (ERP) values as at 31 December of the relevant year from the Australian Bureau of Statistics (ABS). For analysis by remoteness and socioeconomic areas, population denominators were calculated as the average of 30 June estimates for adjacent years.
For general technical notes relating to this report, see also Methods.
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